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South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde

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https://www.readbyqxmd.com/read/28604329/report-on-the-first-government-funded-opioid-substitution-programme-for-heroin-users-in-the-western-cape-province-south-africa
#1
Graeme Michie, Shuaib Hoosain, Muiruri Macharia, Lize Weich
BACKGROUND: Although pharmacological opioid substitution treatment (OST) is a well-established treatment modality for heroin addiction, it is a relatively recent introduction in low- and middle-income countries. OBJECTIVE: To report on a pilot OST programme initiated in 2013 that was the only public-funded programme in South Africa (SA) at the time. Participants were offered standard care only (n=68) or, for the OST group (n=67), standard care plus Suboxone (Reckitt Benckiser), a synthetic partial opioid agonist, in a 12-week clinician-monitored programme...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604328/the-status-of-vaccine-availability-and-associated-factors-in-tshwane-government-clinics
#2
Ntombenhle Judith Ngcobo, Mercy G Kamupira
BACKGROUND: Vaccines have greatly contributed to the control of vaccine-preventable diseases and to human development. Efforts by many countries to introduce new vaccines are a significant move towards achieving the sustainable development goal for health. However, effective vaccine supply chains that ensure an uninterrupted supply of vaccines are pivotal to attaining universal access to life-saving vaccines and sustainable development. The introduction of new vaccines puts a strain on supply chains; South Africa (SA) is no exception, as there are indications of vaccine stock-outs in clinics...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604327/effects-of-exogenous-human-insulin-dose-adjustment-on-body-mass-index-in-adult-patients-with-type-1-diabetes-mellitus-at-kalafong-hospital-pretoria-south-africa-2009-2014
#3
Tohlang Solomon A Sehloho, Danie G Van Zyl
BACKGROUND: To maintain fasting blood glucose levels within near to the normal range in type 1 diabetes mellitus (DM), frequent insulin dose adjustments may be required with short-, intermediate- and long-acting insulin formulations. Patients on human insulin generally experience weight gain over time, regardless of the level of glycaemic control achieved. OBJECTIVES: To determine the effects of human insulin, adjusted quarterly to achieve glycaemic control, on body mass index (BMI), and establish dose regimens that achieve optimal glycaemic control without increasing BMI in patients with type 1 DM at the Kalafong Diabetes Clinic in Pretoria, South Africa...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604326/screening-for-gestational-diabetes-mellitus-in-a-south-african-population-prevalence-comparison-of-diagnostic-criteria-and-the-role-of-risk-factors
#4
Sumaiya Adam, Paul Rheeder
BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is increasing. Most major world organisations now recommend universal screening for GDM based on the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria. Currently there is a lack of consensus on the diagnostic criteria for GDM used in South Africa (SA). The Society for Endocrinology, Metabolism and Diabetes of South Africa's revised guidelines recommend the use of the IADPSG criteria for the diagnosis of GDM...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604325/characteristics-and-outcomes-of-gunshot-acquired-spinal-cord-injury-in-south-africa
#5
Conran Joseph
BACKGROUND: Spinal cord injuries (SCIs) caused by assault present a unique challenge facing the healthcare system, in that very little is known about how these injuries manifest compared with other causes of injury. Understanding the nuances of gunshot SCIs could contribute towards better care provision. OBJECTIVE: To determine the characteristics of gunshot SCI and compare both injury characteristics and outcomes between gunshot SCI and all other traumatic causes taken together...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604324/cytomegalovirus-retinitis-in-cape-town-south-africa-clinical-management-and-outcomes
#6
Steven R J Lapere, James C Rice
BACKGROUND: Cytomegalovirus (CMV) retinitis is a vision-threatening opportunistic infection that occurs mainly in immunocompromised individuals. Limited data on treatment protocols and management outcomes are available in South Africa (SA). OBJECTIVES: To review the clinical presentation, management and outcomes of patients who were diagnosed and treated for CMV retinitis at Groote Schuur Hospital, Cape Town, SA, over a 10-year period, and to compare treatment protocols of 13 public hospitals in SA that treat patients for CMV retinitis...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604323/analysis-of-hiv-disease-burden-by-calculating-the-percentages-of-patients-with-cd4-counts-100-cells-%C3%A2%C2%B5l-across-52-districts-reveals-hot-spots-for-intensified-commitment-to-programmatic-support
#7
Lindi Marie Coetzee, Naseem Cassim, Deborah Kim Glencross
BACKGROUND: South Africa (SA)'s Comprehensive HIV and AIDS Care, Management and Treatment (CCMT) programme has reduced new HIV infections and HIV-related deaths. In spite of progress made, 11.2% of South Africans (4.02 million) were living with HIV in 2015. OBJECTIVE: The National Health Laboratory Service (NHLS) in SA performs CD4 testing in support of the CCMT programme and collates data through the NHLS Corporate Data Warehouse. The objective of this study was to assess the distribution of CD4 counts <100 cells/µL (defining severely immunosuppressed HIV-positive patients) and >500 cells/µL (as an HIV-positive 'wellness' indicator)...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604322/training-and-support-to-improve-icd-coding-quality-a-controlled-before-and-after-impact-evaluation
#8
Robin Dyers, Grant Ward, Shane Du Plooy, Stephanus Fourie, Juliet Evans, Hassan Mahomed
BACKGROUND: The proposed National Health Insurance policy for South Africa (SA) requires hospitals to maintain high-quality International Statistical Classification of Diseases (ICD) codes for patient records. While considerable strides had been made to improve ICD coding coverage by digitising the discharge process in the Western Cape Province, further intervention was required to improve data quality. The aim of this controlled before-and-after study was to evaluate the impact of a clinician training and support initiative to improve ICD coding quality...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604321/sentinel-lymph-node-biopsy-and-neoadjuvant-chemotherapy-in-the-management-of-early-breast-cancer-safety-considerations-and-timing
#9
Jenny Edge, Sarah Nietz
Over the last decades, breast cancer treatment has become more personalised. Treatment plans are based on the biology of the tumour rather than the stage. Consequently, neoadjuvant chemotherapy (NACT) is commonly the primary therapy for early breast cancer as well as locally advanced disease. Sentinel lymph node biopsy (SLNB) is standard axillary management for women with node-negative disease. This review looks at the relevant literature and gives guidance on the timing of SLNB when NACT is planned and evaluates the safety of performing an SLNB rather than an axillary clearance...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604320/audits-of-oncology-units-an-effective-and-pragmatic-approach
#10
Raymond Pierre Abratt, David Eedes, Belinda Bailey, Chris Salmon, Yogi Govender, Ivan Oelofse, Henriette Burger
BACKGROUND: Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. OBJECTIVE: To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. METHODS: Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604319/establishing-an-academic-biobank-in-a-resource-challenged-environment
#11
Cassandra Claire Soo, Freedom Mukomana, Scott Hazelhurst, Michele Ramsay
Past practices of informal sample collections and spreadsheets for data and sample management fall short of best-practice models for biobanking, and are neither cost effective nor efficient to adequately serve the needs of large research studies. The biobank of the Sydney Brenner Institute for Molecular Bioscience serves as a bioresource for institutional, national and international research collaborations. It provides high-quality human biospecimens from African populations, secure data and sample curation and storage, as well as monitored sample handling and management processes, to promote both non-communicable and infectious-disease research...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604318/complementary-medicines-when-regulation-results-in-revolution
#12
Liezl Fourie, Frasia Oosthuizen, Karen Du Toit
Medicines have evolved over time and so has the realisation of the importance of quality control and regulatory processes. The regulatory practices include all the steps from the development and manufacture of the active ingredients until the medicines reach the consumer. The Medicines Control Council (MCC) is mandated to regulate medicines in South Africa. Complementary medicines were previously perceived to be unregulated, although the Medicines Act does not distinguish between allopathic and complementary medicine...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604317/beware-the-femoral-haemodialysis-catheter-a-surgeon-s-perspective
#13
Tinus Du Toit, David Thomson, Elmi Muller
The ability to identify and address factors that threaten the optimal utilisation of donor organs is quintessential in obtaining satisfactory transplant outcomes. We share our concerns regarding the prolonged use of femoral haemodialysis catheters and its potential to jeopardise successful renal transplantation. Despite a paucity of literature on the topic, we review relevant aspects related to this pernicious form of vascular access and clarify its limited role in the modern haemodialysis unit, particularly in patients who are still considered for transplantation...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604316/when-students-become-patients-tb-disease-among-medical-undergraduates-in-cape-town-south-africa
#14
Helene-Mari Van der Westhuizen, Angela Dramowski
BACKGROUND: Medical students acquire latent tuberculosis (TB) infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. METHODS: A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015) at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604315/exploitation-of-the-vulnerable-in-research-responses-to-lessons-learnt-in-history
#15
Amaboo Dhai
The Nuremberg Trials raised insightful issues on how and why doctors who were trained in the Hippocratic tradition were able to commit such egregious and heinous medical crimes. The vulnerable were considered to be subhuman, of decreased intelligence, of no moral status and lacking human dignity. The reputation of the medical profession had been undermined, professionalism questioned and the doctor-patient relationship damaged as a result of the Nazi medical experiments. The World Medical Association's Declaration of Helsinki has been hailed as one of the most successful efforts in rescuing medical research from the darkness of the scandals and tragedies in health research...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28604314/south-africa-s-vital-statistics-are-currently-not-suitable-for-monitoring-progress-towards-injury-and-violence-sustainable-development-goals
#16
Megan Prinsloo, Debbie Bradshaw, Jané Joubert, Richard Matzopoulos, Pam Groenewald
No abstract text is available yet for this article.
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28492130/osteogenesis-imperfecta-type-3-in-south-africa-causative-mutations-in-fkbp10
#17
Alvera Vorster, Peter Beighton, Manogari Chetty, Yasmeen Ganie, Bertram Henderson, Engela Honey, Piet Maré, David Thompson, Karen Fieggen, Denis Viljoen, Rajkumar Ramesar
BACKGROUND: A relatively high frequency of autosomal recessively inherited osteogenesis imperfecta (OI) type 3 (OI-3) is present in the indigenous black southern African population. Affected persons may be severely handicapped as a result of frequent fractures, progressive deformity of the tubular bones and spinal malalignment. OBJECTIVE: To delineate the molecular basis for the condition. METHODS: Molecular investigations were performed on 91 affected persons from seven diverse ethnolinguistic groups in this population...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28492129/codeine-misuse-and-dependence-in-south-africa-perspectives-of-addiction-treatment-providers
#18
Charles D H Parry, Eileen Rich, Marie Claire Van Hout, Paolo Deluca
BACKGROUND: General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. OBJECTIVES: To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. METHOD: Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28492128/validating-the-utilisation-of-venous-bicarbonate-as-a-predictor-of-acute-kidney-injury-in-crush-syndrome-from-sjambok-injuries
#19
David Lee Skinner, Grant L Laing, John Bruce, Bruce Biccard, David J J Muckart
BACKGROUND: Crush injury secondary to sjambok beatings is a well-described phenomenon in southern Africa. Owing to a number of factors, it can result in acute kidney injury (AKI). In 1992, Muckart et al. described a risk stratification system using venous bicarbonate (VB) that can be used in the management of these patients. OBJECTIVE: To validate this score in the modern era of AKI risk stratification. METHODS: A retrospective study was performed on a local trauma database from June 2010 to December 2012...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28492127/obstructive-pulmonary-disease-in-patients-with-previous-tuberculosis-pathophysiology-of-a-community-based-cohort
#20
Brian W Allwood, Rencia Gillespie, Maya Galperin-Aizenberg, Mary Bateman, Helena Olckers, Luis Taborda-Barata, Gregory L Calligaro, Qonita Said-Hartley, Richard Van Zyl-Smit, Christopher B Cooper, Eva Van Rikxoort, Jonathan Goldin, Nulda Beyers, Eric D Bateman
BACKGROUND: An association between chronic airflow limitation (CAL) and a history of pulmonary tuberculosis (PTB) has been confirmed in epidemiological studies, but the mechanisms responsible for this association are unclear. It is debated whether CAL in this context should be viewed as chronic obstructive pulmonary disease (COPD) or a separate phenotype. OBJECTIVE: To compare lung physiology and high-resolution computed tomography (HRCT) findings in subjects with CAL and evidence of previous (healed) PTB with those in subjects with smoking-related COPD without evidence of previous PTB...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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